Sierra Leone has been trying to heal multiple wounds over the past few decades. The civil war from 1991-2002 left the nation with an especially deep cut. Many people fled their rural communities for growing urban areas; cities like Freetown quickly became overcrowded, leading to the appearance of slums almost overnight. According to the World Health Organization’s research, urban overpopulation, lack of sanitation and inadequate health services are key reasons as to why disease and death are so prominent in these locations. This holds especially true for mothers as well as for children under five. Humanitarian aid to Sierra Leone is vital in order to improve the lives of the country’s citizens.

Luckily, nongovernmental organizations like Concern Worldwide have implemented aid programs in Sierra Leone. From October 2011 to June 2017, Concern Worldwide implemented a USAID- and Irish Aid-funded Child Survival Project (CSP), also known as “Al Pikin fo Liv” (Life for Children). This program was designed to reduce maternal, infant and child deaths through the building of key foundations at 10 urban sites in the Freetown Western Urban Area District.

The main concern for completing the program was how to put into operation the national Community Health Worker Policy (CHWP). USAID and Concern Worldwide did this by working with individual health facilities to improve quality of healthcare worker training, apply clinical protocols and providing on-the-job supervision and mentorship. Essentially, the CSP aimed to increase the number of healthcare workers per facility and improve the quality of care that is provided.

This might seem like it doesn’t have a solid correlation to solving maternal, infant, and child mortality. However, while it might be a simpler task to prevent death and offer treatment to an individual, it’s another matter to treat disease and prevent future deaths on a national level. The CSP and the implementation of the CHWP are strategies that are meant to carry on into the future.

It will take a number of years in order to determine the overall success of the humanitarian aid to Sierra Leone on maternal, infant and child health. But, in interviews completed after the program’s end date, many healthcare workers believed they were given the right training and resources in order to continue running efficient facilities and to improve care for patients. The community in general also felt more connected, because households were given increased knowledge about the importance of treatment and the health facilities were partnered with the Freetown City Council, Health Management Committees and Ward Development Committees at each project site.

This sense of unity and a more focused understanding of community-based health in urban settings is a powerful tool to have. It is important that humanitarian aid to Sierra Leone continues to be funded and implemented on the ground, in order to ensure an improved way of life and better futures for all citizens.

Located in Western Africa, bordering the Atlantic Ocean, Sierra Leone has a population of over six million and growing. Rapid population growth rates due to high fertility among women has led to increased need for improved drinking water and sanitation facilities. In 2015, over 93 percent of the rural population had unimproved access to sanitation facilities and over 52 percent had unimproved access to clean drinking water, according to the CIA World Factbook. Sierra Leone’s population is categorized at a “very high risk” of contracting infectious diseases. Here are some common diseases in Sierra Leone that are of issue.

Zika Virus
Spread by the bite of an infected mosquito, Zika virus can be from person to person through intercourse as well as from a pregnant woman to her fetus. Zika is linked to a number of birth defects including incomplete brain development. Many people infected by the virus show no or few symptoms such as fever, rash, headache, red eyes and muscle pain. The Centers for Disease Control and Prevention (CDC) strictly states that women who are pregnant should not travel to Sierra Leone. All travelers should prevent mosquito bites and have minimal sexual contact. The first recorded outbreak of the Zika virus in Sierra Leone was documented by the World Health Organization (WHO) from 1960 to 1983.

Lassa Fever
A viral disease carried by rats, Lassa fever can be contracted through exposure to rodent fecal matter or urine. Within the first week of February 2017, three deaths due to Lassa fever were reported in the city of Kenema in Sierra Leone. According to the CDC, there are an estimated 100,000 to 300,000 documented cases of Lassa virus infections in West Africa every year, with a resulting 5,000 deaths. Lassa fever is more widespread within the country than it ever has been before and is classified as one of the most common diseases in Sierra Leone.

Typhoid Fever
According to the CDC, nearly 26 million cases of typhoid fever are reported annually worldwide. Spread through consumption of water or food contaminated with fecal matter or sewage, the CDC strongly suggests all travelers be vaccinated for typhoid fever if traveling to Sierra Leone. The most vulnerable to contracting the disease in the country are infants ages one to four. The most common symptom is sustained high fever.

Malaria
Transmitted to humans by the bite of an infected female mosquito, malaria can cause fever, chills and eventual anemia due to damage to the vital organs. In 2013, there were a total of 1.7 million recorded cases of the disease in Sierra Leone’s population of six million. The CDC recommends travelers take a prescription medicine before and during travels to Sierra Leone to lower risk of infection. All areas of Sierra Leone are at risk for the malaria epidemic.

Travelers are at high risk for all common diseases in Sierra Leone. Disease detection, control and prevention remain some of the highest priorities of the country’s Ministry of Health and Sanitation.

As of this year, Sierra Leone is an Ebola-free country. However, thousands of lives were lost during the epidemic, and while it may be over, the effects of the disease are still crippling the country, especially economically.

During the epidemic, schools were shut down to prevent further spread of the disease. These closures stalled the learning of almost 1.8 million children. For nine months, the youth of Sierra Leone were not only living in fear of Ebola but also of falling behind in their studies.

With the loss of “181 teachers and 945 students,” according to UNICEF, it was difficult for Sierra Leone to reopen schools again in 2015. Education in Sierra Leone had been on the rise since the end of the country’s civil war in 2002. The Ebola epidemic cracked that stable foundation and led to “an accelerated curriculum to shorten the duration of academic years” to make up for what school-aged children had missed.

Due to the increase of poverty in Sierra Leone, education has been put on the back burner for many families. Many children are now reliant on other family members to care for them, which means they are now less likely to finish their education.

Beginning in 2015, the charity Street Child has been working hard to recover education in Sierra Leone. They have found that 12,000 children no longer have an adult to support them because of Ebola. The CEO of Street Child, Tom Dannatt, said, “…unless we help families out of poverty, their children remain out of school. It is likely that their life prospects will be bleak as a result.”

Street Child runs a program called Livelihoods Programme, which supports the businesses of poor families that cannot afford school for the children they’re responsible for. The program provides grants to start small businesses. Training programs are also available along with these grants.

Another organization, Dubai Cares, started Education in Emergencies: Evidence for Action (3EA), a program focused specifically on recovering education in Sierra Leone. The goal of the program is to “improve teaching methodologies, ways to monitor and mentor staff, and reinforcing teaching styles that improve classroom performance.” 3EA encourages a positive learning environment and fitting the lessons to accommodate each student.

The Livelihoods Programme and Education in Emergencies: Evidence for Action have so far proven to be successful approaches to improving the education system in Sierra Leone. Both have allowed a greater number of children to go back to school, despite the country’s serious poverty. The future generation of Sierra Leone is not going to remain a victim of the Ebola epidemic, thanks to help from charitable organizations and knowledgeable people.

Sierra Leone is a small country in West Africa best known for the large number of high quality diamonds it supplies to the world market. Urbanization is growing in the country. The population living in cities is expected to increase from 39 to 44 percent from 2015 to 2030. Human rights in Sierra Leone appear to be on the rise, but the country ranks 120th worldwide on the Social Progress Index. Why, given the increases in urbanization and economic strength, does the standard of living in Sierra Leone remain so low?

Most of the reasons relate to human rights in Sierra Leone. Or, more accurately, the lack thereof. Even during the 2014-16 Ebola epidemic, when there were 4,000 deaths and more than 13,000 cases of the disease, government funds intended for medical aid disappeared mysteriously, pointing to extraordinary corruption on a national level.

In addition to rampant government corruption, the freedom of the press is minimal in Sierra Leone. The government uses libel laws to target journalists when they pursue the topic of government corruption. Consequently, this obstructs transparency and allows corruption to continue unencumbered.

Even though the Ebola epidemic officially ended in January 2016, numerous health problems still plague the country. Although many of the health centers established to handle the Ebola outbreak remain functional, at least 20 percent don’t have access to running water. In addition, half don’t practice proper waste management techniques.

Due to the recent civil wars, there is no land-titling system. This effectively eliminates any chance for traditional, government-sanctioned property rights. Private businesses require extensive licensing, severely limiting economic freedoms in Sierra Leone.

However, human rights in Sierra Leone are beginning to improve. Before the Ebola outbreak, medical services were few and far between, but the intervention of the World Health Organization has encouraged significant improvement. Since 1995, government corruption has decreased by roughly 20 points in the World Heritage Index. The same holds true in the economic field, where over the same time span, monetary freedom increased by 18 points and freedom of trade has improved by 25.

While Sierra Leone still faces a long journey forward, they have still made significant strides toward improving the quality of life of its citizens.

The U.N. projects that there are more displaced people in the world now than at any other time since World War II. Most of these refugees come from Africa, which has put large demands on European and African countries. Future refugee projections continue to rise due to ongoing conflicts and the effects of climate change. Case studies in Sierra Leone show us the importance of rehabilitating governmental institutions and economic markets in conflict-prone regions.

Here are 10 facts about Sierra Leone refugees.

Thousands of natives fled their country during a bloody civil war that lasted from 1991 to 2002.

The Revolutionary United Front (RUF), with support from the National Patriotic Front of Liberia (NPFL), attempted to overthrow the president at the time, Joseph Momoh.

This 11-year civil war resulted in 50,000 deaths and the internal displacement of two million people. Among the displaced, 490,000 sought refuge in the neighboring countries of Liberia and Guinea.

In 2008, the U.N. High Commission for Refugees conducted a campaign in Guinea. The project aimed to inform Sierra Leone refugees of the upcoming withdrawal of their refugee status.

The UNHCR convened in 2008, and found that conditions in Sierra Leone had returned to normal. This meant that Sierra Leoneans who fled their country during the civil war in the early 1990s would no longer be considered refugees because the root causes of the Sierra Leone refugee problem no longer existed.

This decision was reached after an analysis of the fundamental and positive changes that have taken place in Sierra Leone. A peace agreement was struck between the Joseph Momoh government and the RUF in January of 2002, marking the beginning of these changes.

Under a previous UNHCR initiative, a voluntary repatriation operation that took place from September 2000 to July 2004, more than 179,000 Sierra Leone refugees were able to return home.

There are 13,500 refugees from Sierra Leone who continue to live abroad, 1,825 of whom are living in Guinea, and 2,368 in Liberia.

The UNHCR voluntary repatriation operation for refugees from Sierra Leone ended in July 2004. This program offered financial assistance to refugees to assist in transit and resettlement in Sierra Leone.

The U.N. Development Program (UNDP) continued to work with the local government to ensure that returning refugees were integrating effectively, without stressing markets. Additionally, UNDP continued to meet the needs and priorities of the government through aligning long-term development programs and non-governmental relief actors facilitating recovery.

Sierra Leone ended its 11-year long civil war in 2002 and has since re-established democratic institutions. This restructuring process strengthened Sierra Leone’s government and was essential to the reception of 60,000 Liberian refugees in 2005. Sierra Leone is a shining example for current conflict-rode regions as they look towards the future.

The West African country of Sierra Leone is home to some of the greatest diamond, gold, and titanium mines in the world. Despite this natural wealth, however, more than half of Sierra Leone’s people live below the poverty line. Here are 10 facts about hunger in Sierra Leone:

There are more than 6.4 million people living in Sierra Leone, 52.9 percent of whom live below the national poverty line.

Malnutrition is the greatest cause of child mortality in Sierra Leone, accounting for nearly half of all child deaths. Almost one-third of children under five are chronically malnourished.

Roughly 60 percent of the population lives in rural areas, the majority of whom rely on subsistence agriculture for their livelihoods.

Agriculture, however, has faced many challenges in recent years due to lack of equipment, poor quality seeds, deforestation and climate change. Rice production has declined so significantly that only four percent of farmers produce enough to meet their needs.

Due to these agricultural struggles, the country now imports large amounts of food. Between $200 and $300 million is spent each year importing rice alone, harming local agriculture and increasing the country’s vulnerability to global price fluctuations.

Economic development halted between 1991 and 2001 due to a civil war. This has had lasting impacts on the country’s economy, as approximately 1.5 million people were forced to leave their homes and livelihoods.

The Ebola outbreak also worsened hunger in Sierra Leone. Approximately 280,000 people were made food-insecure due to the disease.

In order to encourage young people to attend school, and to increase the education that is vital to rebuilding the country post-war, many primary schools offer feeding programs.

In areas of the country where agriculture is still not providing enough food to feed the villages, food-for-work and food-for-training programs are in place to help support people as the country’s infrastructure is rebuilt.

The World Food Programme runs a number of programs in order to combat hunger in Sierra Leone. Among them is a supplementary feeding program in order to treat malnutrition in lactating mothers and children under five.

While the country is still struggling to rebuild its economy after repeated crises, progress has been made. Numerous programs have been put in place that are making a significant impact in the fight against hunger in Sierra Leone.

Schools in Sierra Leone reopened in April 2015 after the world’s worst recorded Ebola outbreak. The country’s government, with assistance from the Global Partnership for Education (GPE), made efforts to improve education in Sierra Leone since then. However, the issue of gender inequality and its effects on educational opportunities still needs to be addressed.

When Ebola struck Sierra Leone in 2012 and schools were closed for nine months, approximately $1.45 million from GPE was utilized for Ebola-related efforts. These funds helped provide emergency television and radio school programs for children to watch and listen to while out of school. Approximately 600 hours of radio programs were broadcast.

GPE funds were also allocated to ensure the availability of safe learning environments when schools reopened. 900,000 students benefited when 2,700 schools were disinfected and 5,970 schools received hand-washing stations and supplies.

To mitigate the loss of educational opportunities due to the nine-month hiatus, the government of Sierra Leone, assisted by the International Rescue Committee (IRC), also implemented two shortened academic years with accelerated syllabi.

According to the U.N. Population Fund (UNFPA), approximately 18,000 teenage girls became pregnant during the Ebola outbreak. Researchers have identified rape, abusive relationships and prostitution as factors contributing to the spike.

Sierra Leone’s education ministry has decidedly barred pregnant girls from attending school, suggesting that they would be unable to perform well in class. The ministry believed that exposing pregnant girls to classmates would both humiliate them and encourage others to become pregnant.

According to Business Insider, only 15 percent of girls reach secondary school in Sierra Leone, and only six out of 10 girls aged 15 to 24 are literate, compared to three out of four boys in that age range. The ministry’s band will only worsen the gender disparity prevalent in Sierra Leone’s education system.

The United Nations and UNICEF have both launched classes for pregnant students, hoping to relieve gender inequality. In addition to this, UNICEF has initiated programs to educate the community about teenage pregnancy through awareness and training.

The Ebola crisis has been a testament to the resilience of Sierra Leone’s citizens and has given the government an opportunity to reorganize and strengthen the country’s educational programs.

However, this crisis also highlighted the system’s gender inequality and weaknesses. Providing women with educational opportunities has been proven to raise countries’ GDPs. Narrowing the gender gap in education in Sierra Leone, therefore, should be a priority.

As one of the poorest countries in the world, Sierra Leone is ranked 180 out of 187 on the U.N.’s Human Development Index and faces many challenges to creating sustained development. The year 2012, the last year for which official statistics are available, put the proportion of the population below the poverty line at 60 percent. Since the recent Ebola outbreak, current estimates indicate that 77.5 percent of the population suffers from poverty in Sierra Leone.

Ebola Epidemic and its Consequences

The Ebola epidemic significantly set back the progress made by the West-African nation since the end of its long civil war in 2002. Taking around four thousand lives, and disrupting the country’s health system, the outbreak rocked the developing country.

Until the outbreak, Sierra Leone made numerous strides in multiple aspects of development. The country was cited as a success story of peacebuilding missions and establishing good governance and stable institutions. GDP growth averaged over 7 percent every year for the past decade, but shrank to 2 percent after the West-African Ebola crisis.

Sierra Leone’s Global Reliance

The country is heavily reliant on exports of iron ore to support its domestic economy, contributing to GDP more than all other factors combined. Most of the rest of the country’s revenue comes from agricultural products, which remain at low productivity levels across the board.

Additionally, the country has a high dependence on foreign aid, with more than half of investment coming from foreign sources.

Despite progress, lack of infrastructure and high youth unemployment remain large barriers to the country elevating to a middle-income status. With 70 percent of its youth unemployed, and only about 40 percent of adults able to read, significant investments in economic development and education remain high priorities to eradicate poverty in Sierra Leone.

The poor nation also has one of the highest infant mortality rates in the world, with over 71 deaths per 1,000 live births.

Essential International Aid

Many international groups are engaging in efforts to reduce the level of poverty in Sierra Leone including the International Finance Corporation branch of the World Bank, which is investing in many critical areas to boost economic and private sector development to hopefully make the country a self-sustaining middle-income country.

Additionally, the International Rescue Commission provides humanitarian relief efforts through local engagement to prevent death by preventable diseases. The organization accomplishes such feats through its healthcare and educational assistance which improves future prospects.

While the rise of Ebola may have temporarily derailed development efforts, Sierra Leone continues to march toward improved economic and social conditions with help from international organizations. While challenges exist, the country has been consistently improving since 2002.

The country hopes to bounce back from its recent hiccup as quickly as possible and to begin addressing the issue of poverty in Sierra Leone, which prevents it from becoming a middle income country.

In examination of the ten poorest cities in the world, all ten of them are in Africa. In a Western African country on the coast lies a city full of slums. Theorists suggest the poorest city in the world is in Monrovia, the capital city of Liberia. The population of Liberia is currently 4,294,000 and is one of the least populated countries in Africa. It is considered the fifth poorest country, despite being the oldest independent country.

The population suffers from poverty and hunger despite numerous political administrations and new policies being introduced. According to the United Nations’ The Food and Agriculture Organization, Liberia is a low-income and food-deficit country. Over half of the country’s population is food-insecure or highly vulnerable to food insecurity.

Twenty-nine percent of the population of the country live in Monrovia, for a total of 1,010,970 residents. At the turn of the century, 80 percent of the people living in the city were living in poverty.The gross national income is estimated at $790 USD annually. However, eighty-five percent of the population lives on less than one USD per day.

Conflict with neighboring country, Sierra Leone, has had a major impact on the city. Despite the civil war that ended twelve years ago, the city still endures the effects. The constant turmoil between the two countries has caused the educational system to be broken down, abject poverty and inadequate educational access in these slums. The children of Monrovia continue to be subjected to the cycle of both poverty and illiteracy.

On the outskirts of the city, the agricultural sectors have major challenges that compounds its poverty. There are low yields as a result of technological disadvantages. Inadequate roads and little to no access to markets limits the possible value chains. A majority of the people who live in these rural areas suffer from poverty.

In Monrovia, basic necessities are rarely available. Electricity and water resources are scarce and at best unreliable. Both the health care and social services are lacking. The GDP, the health expenditures is ten percent and the amount of health expenditures per capita is eight dollars USD annually. Slums are rampant with disease due to the flooding that has occurred. The streets of Monrovia are filthy, dangerous and unfinished, making it very unsafe to drive on them. The city lacks an infrastructure and public transportation despite being the capital city. In Monrovia, the crime index is 82.81, and has a safety index of 17.19. Over the last three years, the crime rate has increased in the city.

Liberia is a country that is the home of many precious gem and diamond mines. Violent acts and war crimes are ongoing for power struggles over their control. This has left the city war-torn and vulnerable as a result of the exploitation of no true supply chain.The resource rich country suffers from the pandemic of poverty and hunger. Monrovia is a city that depicts global poverty’s existence even in a naturally wealthy country.

On August 17, Sierra Leone began to display signs of truly positive results — an epidemiological week had passed, and Sierra Leone reported no new Ebola cases since the beginning of the outbreak in 2014.

Efforts in Sierra Leone have now entered what is known as “Phase 3,” in which efforts are concentrated on swiftly closing any remaining chains of transmission that may remain. This procedure involves tracking down every single person who may have come into contact with the chain, monitor the subject for 21 days and immediately transfer them to a treatment center if symptoms begin to develop.

As of now, there exists only one remaining open chain that has its source in Freetown and extends into Tonkolili. The chain was carried via a young man who used to worked in Freetown and returned home each month with food and money for his family.

Dr. Anders Nordstrom, WHO representative in Sierra Leone, asserts, “This is very good news but we have to keep doing this intensive working with communities to identify potential new cases early and to rapidly stop any Ebola virus transmission.”

The WHO’s Director-General, Dr. Margaret Chan, has called for reforms throughout her organization in order to facilitate future preparations for potential similar outbreaks, “including the establishment of a global health emergency workforce, an operational platform that can shift into high gear quickly, performance benchmarks and avenues aimed at acquiring the needed funding.”

As recovery in West Africa begins, it is important not to forget that the outbreak had far-reaching consequences for many vulnerable populations. For example, 70,000 Liberian children were not registered at birth during the outbreak, leaving them “vulnerable to marginalization and exclusion,” as well as unable to access social services and healthcare, without official identity documentation and at risk of being trafficked or unlawfully adopted.

In 2013, before the outbreak took place, Liberia had about 79,000 registered births. In 2014, due to medical facilities’ closures, registered births decreased 39 percent to a mere 48,000. Sierra Leone also experienced the same drop in birth registrations during the outbreak, as demonstrated in a recent registration and vaccination campaign in which 250,000 children were in need of registration.